Outcomes for patients must be a core variable in this complex research
The report by Oldmeadow and colleagues (→ Experienced physiotherapists as gatekeepers to hospital orthopaedic outpatient care) in this issue of the Journal details an evaluation of assessment by physiotherapists as an alternative to orthopaedic surgeon management of patients referred by general practitioners for musculoskeletal conditions.1 The authors describe a service funded by the “Better Skills, Best Care” initiative of the Victorian Department of Human Services, whereby two highly qualified physiotherapists screened patients with uncomplicated conditions before parallel assessment by a surgeon. Their conclusions were that the service was beneficial (reduced waiting lists), acceptable (with good levels of satisfaction among all stakeholders) and of high quality (most physiotherapist management decisions were in accord with those of the surgeon).
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Comments in this editorial are partly based on research carried out to explore the evidence of effectiveness of extended scope practice in the United Kingdom. This work was funded by the UK National Health Service National Institute for Health Research Service Delivery and Organisation program.